Clermont, Bianca

Clermont, Bianca is an individual health care provider with primary practice located at 5802 N 30Th St , Tampa FL 33610-1469. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Clermont, Bianca can be contacted via phone (813) 236-5100.

Contact Information

Primary practice address
5802 N 30Th St Tampa FL 33610-1469
Phone: (813) 236-5100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 11001853 Florida

Profile Details

NPI number 1417416843
LBN Legal business name Clermont, Bianca
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2019
Last updated Oct 26th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417416843 NPPES
Florida Other HRJBN BLUE CROSS BLUE SHIELD
Florida Other L7264 BLUE CROSS BLUE SHIELD
Florida MEDICAID 105452900 BLUE CROSS BLUE SHIELD

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